Objectives: Chronic anterior knee pain has been considered as the most frequent postoperative complication of tibial nailing surgery technique. Surgical approaches used for tibial intramedullary nailing are medial parapatellar, transtendinous and lateral parapatellar technic but lateral parapatellar approach is less preferred. The aim of this study was to determine the role of medial parapatellar and transtendinous approach on anterior knee pain of the patients have tibial diaphyseal fracturtes treated with intramedullary nail.

Patients and Methods: Between January 2015 and January 2017, 132 patients who were admitted to our emergency clinic with tibial shaft fracture were evaluated retrospectively. 45 of the 132 patients were treated with intramedullary nail included in this study. Medial parapatellar approach was used in 20 fractures and transtendinous approach in 27 fractures.

Results: The mean follow - up period of the patients was 12 months (6 - 15 months). Mean union time of fractures was 5 months (3 - 15 months). Severity of anterior knee pain was assessed by Visual Analog Scale (VAS). There was no statistically significant difference between the medial parapatellar method and the transtendinous method according to proximal nail entry exposures in the anterior knee pain (p=0,927).

Conclusion: In conclusion, although tibial nailing is a highly successful procedure for fracture healing, anterior knee pain remains the main disadvantage of it. Although our data showed no differences between the groups, the groups were relatively small to accept this null hypothesis with full confidence.